MORPHOLOGICAL SUBSTANTIATION OF SOMATIC COMPLICATIONS DURING USE OF CEMENT IN KNEE AND HIP JOINT REPLACEMENT
Dmitriy Viktorovich ZHUKOV1, Ivan Vasilyevich RYBALKO2
1Novosibirsk State Medical University of Minzdrav of Russia zhukdv@ngs.ru 2State Novosibirsk Regional Clinical Hospital
Keywords: цементное эндопротезирование, суставы, метилметакрилат
Abstract
Cement in joint replacement
remains the main treatment method for patients with injuries and
diseases of major joints. It allows eliminating patient’s pain,
correcting the axis and length of the limb, to restore the
supportability of the limb and return the patient’s activity. At the
same time, it is a very complex treatment method, which requires careful
preparation and a rather long postoperative rehabilitation period.
Cement prosthetics are most often used in elderly patients with
osteoporosis, and, as a rule, with the presence of comorbidities that
complicate surgical treatment, and occasionally prevent its
implementation. The study of morphological changes occurring in organs
and tissues is a necessary step in the study of pathogenesis. Thorough
knowledge of these processes allows to develop pathogenetically based
methods of prevention or to choose the most appropriate method of
treatment. This determined the purpose of the study: on the basis of
morphological, experimental data to study the features of somatic and
cognitive complications that occur during cement endoprosthetics of the
knee and hip joints. An experimental model (95 Wistar rats) of a femur
fracture was used to study the effects of intramedural administration of
methyl methacrylate. The results were studied after 1 hour, after 1, 3,
7, 30 days. Histological studies (preparations of the femur, brain
tissue, heart, lungs, liver, kidneys) were carried out according to
standard methods. The results indicate the combined nature of the
effects on the body: there is mechanical damage, thermal effects and
toxic effects of the methyl methacrylate monomer. The experiment showed
that «bone cement implantation syndrome» is not limited only to impaired
function of the cardiovascular and respiratory systems, as well as data
on impaired renal function, liver, and signs of postoperative cognitive
dysfunction.
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